Taboos surrounding human waste have resulted in a lack of attention to spatial inequalities in access to sanitation and the consequences of this for human, environmental and economic health. This paper explores spaces where urgent environmental health imperatives intersect with deeply entrenched cultural norms surrounding human waste and the barriers they create for the development of more appropriate excreta management systems. The primary focus is on the global South (particularly India), although literature on sanitation histories in Europe and its colonies is drawn upon to illustrate spatial and temporal differences in cultural attitudes towards excrement.